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I have again to report an entire absence of deaths from
small-pox since 1885, with the exception of one in 1886, which
occurred in the person of a tramp, who sickened on the night
he was received into our casual ward. Although no death has
been registered in the district, yet a few cases have occurred
during these years; but most were imported, and no source of
infection could be ascertained in the other two or three cases.
There has not been such previous immunity from the disease
since my appointment, as, although in 1858 no death was
registered in the district, yet there were deaths in each year
before and after it. Subsequent to the great epidemic of 1871-2,
the deaths in the district were very few for a long time, as
9, 5, and 2 occurred respectively in the years 1873, 1874, and
1875, followed by the outbreak of 1876-8; but after the
outbreaks of 1881 and 1884 there was not so marked a cessation
of the disease. How far the earlier and more frequent
re-vaccinations lately carried out have had to do with this I
cannot say, but knowing, as I do, the almost perfect immunity
from a subsequent attack furnished by successful re-vaccination, I
attribute much of the entire absence of death from small-pox
to this cause.
Measles.—The late epidemic of measles in 1887 and 1888
was unusually severe, as 115 deaths were registered
in the former, and 128 in the latter year. The number
of deaths did not, however, equal those in 1885, when
the mortality reached 168 deaths, or in 1881, when 149
deaths were registered. The disease has in this district been
unusually fatal since 1885, as in 1886 the mortality was large,
viz., 88, so that the large number of deaths in 1887 and 1888
was contrary to the usual progress of the disease. Owing to
the continuance of measles for so long a time, the Managers of
the Metropolitan Asylums Board have been requested to receive
cases into their hospitals, and have replied they have no power
to do so. I am of opinion that it is not advisable they should
adopt this proposal, as measles is probably more infectious than